Short-acting antimuscarinic (SAMA)
Anticholinergic bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (chronic bronchitis and emphysema), alone or with other bronchodilators, especially beta-adrenergics.
Also known as: Atrovent, ipratrópio, ipratropium
DailyMed approved label (Ipratropium Bromide Solution; setID 6b730dd7-4d93-403a-bfd2-fa0efa298b75).
DailyMed approved label (Ipratropium Bromide Solution; setID 6b730dd7-4d93-403a-bfd2-fa0efa298b75).
No documented drug–drug interactions for this medicine.
Ipratropium is given by inhalation; food does not affect its pharmacokinetics.
May be administered regardless of meals.
DailyMed approved label (Ipratropium Bromide Solution; setID 6b730dd7-4d93-403a-bfd2-fa0efa298b75).
No relevant pharmacokinetic interaction; usual moderation during treatment.
Moderate alcohol intake.
DailyMed approved label (Ipratropium Bromide Solution; setID 6b730dd7-4d93-403a-bfd2-fa0efa298b75).
The anticholinergic effect may worsen urinary retention.
Use with caution in patients with obstructive urinary symptoms.
EMC-UK (MHRA) — approved Ipratropium bromide SmPC: https://www.medicines.org.uk/emc/product/61/smpc
Inhalation of anticholinergics may precipitate an acute angle-closure glaucoma attack.
Avoid contact with the eyes; use with caution in patients with glaucoma.
EMC-UK (MHRA) — approved Ipratropium bromide SmPC: https://www.medicines.org.uk/emc/product/61/smpc
Data on ipratropium in pregnancy are limited; use only if needed.
Avoid unless usual bronchodilators are insufficient.
Excreted in small amounts into breast milk; probably compatible.
No specific additional contraception.
EMC-UK (MHRA) — approved Ipratropium bromide SmPC: https://www.medicines.org.uk/emc/product/61/smpc
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Bronchodilation predominantly local and site-specific: antagonism of acetylcholine at muscarinic receptors of bronchial smooth muscle prevents the rise of intracellular cyclic GMP, reversing cholinergic bronchoconstriction.
Competitive antagonism of acetylcholine at bronchial muscarinic receptors (parasympatholytic action), blocking vagally mediated reflexes.
After nebulization of 2 mg, only ~7% of the dose reaches the systemic circulation (from the lung or GI tract). Minimal (0–9%) plasma protein binding.
Partially metabolized; excretion is predominantly fecal (much of the inhaled dose is swallowed and not absorbed).
Elimination half-life ~1.6 h after intravenous administration.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
